WEST TENNESSEE HEALTHCARE FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
WEST TENNESSEE HEALTHCARE FOUNDATION (EIN 58-1671241)
Tax period
2012-07-01 to 2013-06-30
Filed
2013-10-22
IRS object ID
201302959349300005
Schema version
2012v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-10-22T08:38:45-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ALEXANDER THOMPSON ARNOLD PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1227 OIL WELL RDAddressLine1
CityJACKSONCity
StateTNState
ZIP Code38305ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN581671241EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WEST TN HEALTHCARE FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWESTNameControl
Phone7319842141Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1620 SKYLINE DRIVEAddressLine1
CityJACKSONCity
StateTNState
ZIP Code38301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFRANK MCMEENName
TitleDIRECTORTitle
Phone7319842141Phone
Date Signed2013-10-08DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJACK M MATTHISName
Phone7314278571Phone
Date Prepared2013-10-08DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonFRANK MCMEENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1620 SKYLINE DRIVEAddressLine1
CityJACKSONCity
StateTNState
ZIP Code38301ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4871947GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionEDUCATION AND OUTREACH TO SUPPORT THE MINISTRY OF HEALTH AND HEALING THROUGHOUT WEST TENNESSEEActivityOrMissionDescription
Nbr Voting Members Governing Body26NbrVotingMembersGoverningBody
Nbr Independent Voting Members26NbrIndependentVotingMembers
Total Nbr Employees5TotalNbrEmployees
Total Nbr Volunteers150TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year3402750ContributionsGrantsPriorYear
Contributions Grants Current Year4176557ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year172437InvestmentIncomePriorYear
Investment Income Current Year440327InvestmentIncomeCurrentYear
Other Revenue Prior Year186158OtherRevenuePriorYear
Other Revenue Current Year202813OtherRevenueCurrentYear
Total Revenue Prior Year3761345TotalRevenuePriorYear
Total Revenue Current Year4819697TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1646747GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2727999GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year326706SalariesEtcPriorYear
Salaries Etc Current Year330122SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year164503OtherExpensePriorYear
Other Expenses Current Year126137OtherExpensesCurrentYear
Total Expenses Prior Year2137956TotalExpensesPriorYear
Total Expenses Current Year3184258TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1623389RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1635439RevenuesLessExpensesCY
Total Assets BOY21498199TotalAssetsBOY
Total Assets EOY24752076TotalAssetsEOY
Total Liabilities BOY948386TotalLiabilitiesBOY
Total Liabilities EOY879153TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY20549813NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY23872923NetAssetsOrFundBalancesEOY
Mission DescriptionEDUCATION AND OUTREACH TO SUPPORT THE MINISTRY OF HEALTH AND HEALING THROUGHOUT WEST TENNESSEEMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense2727999Expense
Grants2727999Grants
DescriptionFUNDS DISBURSED FOR HEALTHCARE AND EDUCATIONAL PURPOSES FOR THE NEEDY OF WEST TENNESSEEDescription
Total Program Service Expense2727999TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundstrueDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Number Forms Transmitted With109619NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees5NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Taxable DistributionsfalseTaxableDistributions
Distribution To DonortrueDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members26NbrVotingGoverningBodyMembers
Number Independent Voting Members26NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledTNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKRIS BIRDINENamePerson
Telephone Number7319842140TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1708 WEST FORREST AVEAddressLine1
CityJACKSONCity
StateTNState
ZIP Code38301ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
FRANK MCMEEN
DIRECTOR40.00XX10266900
HARBERT ALEXANDER
VICE CHAIR1.00XX000
FRANK CHRISTIE
BOARD MEMBER1.00X000
ROBERT CALDWELL
CHAIR1.00XX000
PATSY CAMP
BOARD MEMBER1.00X000
GREG ALEXANDER
BOARD MEMBER1.00X000
THERESA BLEDSOE
BOARD MEMBER1.00X000
ROY HEATHERLY
SECRETARY1.00X000
CARL KIRKLAND
BOARD MEMBER1.00X000
JAKE MCINNIS
NOMINATIONS1.00X000
DANA CAREY
BOARD MEMBER1.00X000
MARY JANE MCWHERTER
BOARD MEMBER1.00X000
JAY SATTERFIELD
TREASURER1.00XX000
SAM HAMADY
BOARD MEMBER1.00X000
BILL RICHARDSON
BOARD MEMBER1.00X000
MELVIN WRIGHT
BOARD MEMBER1.00X000
ROBERT WALDEN
ALLOCATIONS1.00X000
JIM OVERALL
BOARD MEMBER1.00X000
BILL BUCKLEY
BOARD MEMBER1.00X000
SUSAN COX
BOARD MEMBER1.00X000
TIM CROSSETT
BOARD MEMBER1.00X000
BEN MARKS
CAMDEN CHAPT1.00X000
JERRY SMITH
BOARD MEMBER1.00X000
ASHLEY TEAGUE
BOARD MEMBER1.00X000
KATHY WATTS
BOARD MEMBER1.00X000
BILL WHITE
BOARD MEMBER1.00X000
DON YOUNG
BOLIVAR CHAP1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org102669TotalReportableCompFromOrg
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Government Grants157864GovernmentGrants
All Other Contributions4018693AllOtherContributions
Noncash Contributions394786NoncashContributions
Total Contributions4176557TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column440327TotalRevenueColumn
Exclusion$440,327ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events255063GrossIncomeFundraisingEvents
Fundraising Direct Expenses52250FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column202813TotalRevenueColumn
Exclusion$202,813ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4819697TotalRevenueColumn
Exclusion$643,140ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2727999Total
Program Services2727999ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total102669Total
Management And General102669ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total188509Total
Management And General188509ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total38944Total
Management And General38944ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1866Total
Management And General1866ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total41144Total
Management And General41144ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total19881Total
Management And General19881ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total4598Total
Management And General4598ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total32322Total
Management And General32322ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneral
MISCELLANEOUS2350623506
DUES AND SUBSCRIPTIONS28202820

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3184258Total
Program Services2727999ProgramServices
Management And General456259ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY901619BOY
EOY801820EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY24238BOY
EOY44199EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1315748LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec173668LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1174401BOY
EOY1142080EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY19397941BOY
EOY22763977EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY21498199BOY
EOY24752076EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1053BOY
EOY64EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY947333BOY
EOY879089EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY948386BOY
EOY879153EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3818681BOY
EOY4815571EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4176465BOY
EOY5894885EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY12554667BOY
EOY13162467EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20549813BOY
EOY23872923EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY21498199BOY
EOY24752076EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1635439ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1687671ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2681226CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8374519CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3244347CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3402750CurrentTaxYearMinus1Year
Current Tax Year4176557CurrentTaxYear
Total21879399Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2681226CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8374519CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3244347CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3402750CurrentTaxYearMinus1Year
Current Tax Year4176557CurrentTaxYear
Total21879399Total
FieldValueIRS element (for citing)
Public Support Total17021879399PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year440327CurrentTaxYear
Total440327Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years127063CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year162729CurrentTaxYearMinus1Year
Current Tax Year201813CurrentTaxYear
Total491605Total
FieldValueIRS element (for citing)
Total Support22811331TotalSupport
Public Support Pertcentage1700.95910PublicSupportPertcentage170
Public Support Pertcent Prior Year0.98800PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Number DA Fs Held9NumberDAFsHeld
Number Funds Held482NumberFundsHeld
Grants Paid From Donor Funds134280GrantsPaidFromDonorFunds
Aggregate DAF Value455973AggregateDAFValue
Aggregate Fund Value22077883AggregateFundValue
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposestrueDisclosedForCharitablePurposes

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance16731132BeginningOfYearBalance
Contributions3554502Contributions
Investment Earnings Or Losses1288061InvestmentEarningsOrLosses
Other Expenditures2516343OtherExpenditures
End Of Year Balance19057352EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance15413048BeginningOfYearBalance
Contributions2626184Contributions
Investment Earnings Or Losses290442InvestmentEarningsOrLosses
Other Expenditures1598541OtherExpenditures
End Of Year Balance16731133EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance12997974BeginningOfYearBalance
Contributions2317303Contributions
Investment Earnings Or Losses1609267InvestmentEarningsOrLosses
Other Expenditures1511496OtherExpenditures
End Of Year Balance15413048EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
End Of Year Balance12997974EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.69000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.31000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis400100OtherCostOrOtherBasis
Book Value400100BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis879648OtherCostOrOtherBasis
Depreciation144918Depreciation
Book Value734730BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis36000OtherCostOrOtherBasis
Depreciation28750Depreciation
Book Value7250BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1142080TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO JMCGH$736,000
ANNUITY GIFT LIABILITIES$116,833
AFFILIATE CLEARING$26,256
FieldValueIRS element (for citing)
Total Of Amounts879089TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt6559618TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1687671NetUnrealizedGainsInvestments
Other Revenues52250OtherRevenues
Revenue Not Rptd F9901739921RevenueNotRptdF990
Revenue Subtotal4819697RevenueSubtotal
Total Revenue Per Form9904819697TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3236508TotExpensesEtcAuditedFinclStmt
Other Expenses Included52250OtherExpensesIncluded
Expenses Not Rptd F99052250ExpensesNotRptdF990
Expenses Subtotal3184258ExpensesSubtotal
Total Expenses Per Form9903184258TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 2DFUNDRAISING EXPENSES REPORTED AS EXPENSE IN FINANCIALS 52,250
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DFUNDRAISING EXPENSES REPORTED AS EXPENSE IN FINANCIALS 52,250

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Licensed StatesTNLicensedStates

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GALANameOfEvent1
Gross Receipts Event1203305GrossReceiptsEvent1
Gross Revenue Event1203305GrossRevenueEvent1
Non Cash Prizes Event11506NonCashPrizesEvent1
Rent Facility Costs Event130275RentFacilityCostsEvent1
Food And Beverage Event14298FoodAndBeverageEvent1
Entertainment Event12500EntertainmentEvent1
Other Direct Expenses Event12673OtherDirectExpensesEvent1
Name Of Event2STRIKES FOR TIKNameOfEvent2
Gross Receipts Event242798GrossReceiptsEvent2
Gross Revenue Event242798GrossRevenueEvent2
Cash Prizes Event2100CashPrizesEvent2
Non Cash Prizes Event21870NonCashPrizesEvent2
Rent Facility Costs Event26243RentFacilityCostsEvent2
Food And Beverage Event2317FoodAndBeverageEvent2
Other Direct Expenses Event21327OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events8960GrossReceiptsOtherEvents
Gross Revenue Other Events8960GrossRevenueOtherEvents
Food And Beverage Other Events595FoodAndBeverageOtherEvents
Other Direct Expenses Other Events546OtherDirectExpensesOtherEvents
Gross Receipts Total255063GrossReceiptsTotal
Gross Revenue Total Events255063GrossRevenueTotalEvents
Cash Prizes Total Events100CashPrizesTotalEvents
Non Cash Prizes Total Events3376NonCashPrizesTotalEvents
Rent Facility Costs Total Events36518RentFacilityCostsTotalEvents
Food And Beverage Total Events5210FoodAndBeverageTotalEvents
Entertainment Total Events2500EntertainmentTotalEvents
Other Direct Expenses Total Events4546OtherDirectExpensesTotalEvents
Direct Expense Summary Events52250DirectExpenseSummaryEvents
Net Income Summary202813NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (65 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
ALLISON FAMILY COMMUNITY FUND
620 SKYLINE DRIVEJACKSONTN3830158167124135250CHARITABLE
AYERS CHILDREN MEDICAL CENTER
620 SKYLINE DRIVEJACKSONTN383015816712413156980CHARITABLE
BALLARD MCCALLUM PROFESSORSHIP
620 SKYLINE DRIVEJACKSONTN38301581671241341413CHARITABLE
BRAY ALMA FUND
620 SKYLINE DRIVEJACKSONTN3830158167124137897CHARITABLE
BREAST CANCER AWARENESS
620 SKYLINE DRIVEJACKSONTN38301581671241316196CHARITABLE
BUTTON FAMILY DONOR FUND
620 SKYLINE DRIVEJACKSONTN38301581671241327280CHARITABLE
CAMP BLUEBIRD OPERATING
620 SKYLINE DRIVEJACKSONTN38301581671241310682CHARITABLE
CAMP WINGS CHILDRENS GRIEF CAMP
620 SKYLINE DRIVEJACKSONTN38301581671241312678CHARITABLE
CANCER CARE
620 SKYLINE DRIVEJACKSONTN38301581671241311185CHARITABLE
CHANCE'S ADVENTURE
620 SKYLINE DRIVEJACKSONTN3830158167124136575CHARITABLE
CHESTER CO NURSING HOME BENEVOLENCE
620 SKYLINE DRIVEJACKSONTN3830158167124137000CHARITABLE
CHYANNE SCOTT FUND
620 SKYLINE DRIVEJACKSONTN3830158167124138892CHARITABLE
CME
620 SKYLINE DRIVEJACKSONTN38301581671241315686CHARITABLE
COMMUNITY FUND
620 SKYLINE DRIVEJACKSONTN3830158167124139312CHARITABLE
CROSSETT SPECIAL NEEDS
620 SKYLINE DRIVEJACKSONTN38301581671241343552CHARITABLE
DEPUTY DALE WYMAN BENEFIT FUND
620 SKYLINE DRIVEJACKSONTN38301581671241334447CHARITABLE
DIABETIC CARE
620 SKYLINE DRIVEJACKSONTN3830158167124136369CHARITABLE
EL CAMINO
620 SKYLINE DRIVEJACKSONTN38301581671241325331CHARITABLE
ENTREPRENEUR DEVELOPMENT CTR
620 SKYLINE DRIVEJACKSONTN383015816712413327534CHARITABLE
EWOH CHARITABLE FUND
620 SKYLINE DRIVEJACKSONTN3830158167124137120CHARITABLE
FRIENDS OF MORGAN KELLEY
620 SKYLINE DRIVEJACKSONTN3830158167124139780CHARITABLE
GIRL SCOUTS
620 SKYLINE DRIVEJACKSONTN3830158167124135750CHARITABLE
GLORY TO GOD
620 SKYLINE DRIVEJACKSONTN38301581671241367380CHARITABLE
GREER CAMPAIGN
620 SKYLINE DRIVEJACKSONTN38301581671241364048CHARITABLE
HAITIAN MEDICAL AND DENTAL TEAM
620 SKYLINE DRIVEJACKSONTN38301581671241329176CHARITABLE
HANDS UP
620 SKYLINE DRIVEJACKSONTN383015816712413258913CHARITABLE
HAYWOOD CO COLLEGE ACCESS
620 SKYLINE DRIVEJACKSONTN3830158167124136250CHARITABLE
HUDSON'S HOPE
620 SKYLINE DRIVEJACKSONTN3830158167124137706CHARITABLE
JOHNSTON FAMILY FUND
620 SKYLINE DRIVEJACKSONTN3830158167124135750CHARITABLE
JACKSON CHORAL SOCIETY
620 SKYLINE DRIVEJACKSONTN38301581671241328908CHARITABLE
JHS ROBOTICS
620 SKYLINE DRIVEJACKSONTN3830158167124137846CHARITABLE
JMCGH PHARMACY
620 SKYLINE DRIVEJACKSONTN3830158167124136932CHARITABLE
JUMP START JACKSON
620 SKYLINE DRIVEJACKSONTN3830158167124135425CHARITABLE
KCC - ACS TRANS GRANT
620 SKYLINE DRIVEJACKSONTN3830158167124136427CHARITABLE
KCC EDUCATION
620 SKYLINE DRIVEJACKSONTN3830158167124137264CHARITABLE
KELLY CARLA EMS
620 SKYLINE DRIVEJACKSONTN3830158167124136343CHARITABLE
KIRKLAND CARL AND ALICE
620 SKYLINE DRIVEJACKSONTN38301581671241365000CHARITABLE
LULLABY LANE
620 SKYLINE DRIVEJACKSONTN38301581671241318265CHARITABLE
MADISON CAN OPERATION
620 SKYLINE DRIVEJACKSONTN38301581671241353352CHARITABLE
MCKINNEY MEMORIAL HOSPITAL
620 SKYLINE DRIVEJACKSONTN3830158167124136945CHARITABLE
MD ANDERSON
620 SKYLINE DRIVEJACKSONTN38301581671241379558CHARITABLE
MEEKS ANTHONY CHARITABLE
620 SKYLINE DRIVEJACKSONTN38301581671241311096CHARITABLE
MICAH FUND
620 SKYLINE DRIVEJACKSONTN3830158167124135500CHARITABLE
MORE THAN A MISSION
620 SKYLINE DRIVEJACKSONTN38301581671241312529CHARITABLE
MYHR DR LAMB INDIGENT FUND
620 SKYLINE DRIVEJACKSONTN38301581671241311109CHARITABLE
NATURALS BASEBALL CLUB
620 SKYLINE DRIVEJACKSONTN3830158167124136296CHARITABLE
NORTHWEST CASA
620 SKYLINE DRIVEJACKSONTN38301581671241315067CHARITABLE
PM&R EMPLOYEE ASST FUND
620 SKYLINE DRIVEJACKSONTN38301581671241315871CHARITABLE
REHABILITATION HUMANITARIAN
620 SKYLINE DRIVEJACKSONTN3830158167124137248CHARITABLE
ROTARY CHARIABLE
620 SKYLINE DRIVEJACKSONTN3830158167124139453CHARITABLE
ROTARY YOUTH TOWN
620 SKYLINE DRIVEJACKSONTN3830158167124138294CHARITABLE
RWANDAN EDUCATION ASST FUND
620 SKYLINE DRIVEJACKSONTN38301581671241311813CHARITABLE
SIMPSON JOHN CHARITABLE FUND
620 SKYLINE DRIVEJACKSONTN38301581671241312500CHARITABLE
SPECIAL NEEDS ATHLETICS FOUNDATION
620 SKYLINE DRIVEJACKSONTN38301581671241313047CHARITABLE
STAR CENTER
620 SKYLINE DRIVEJACKSONTN3830158167124135500CHARITABLE
THERAPY AND LEARNING CENTER
620 SKYLINE DRIVEJACKSONTN38301581671241366633CHARITABLE
TN HEART & VASCULAR CENTER
620 SKYLINE DRIVEJACKSONTN38301581671241315791CHARITABLE
TRAUMA CENTER
620 SKYLINE DRIVEJACKSONTN38301581671241321526CHARITABLE
UNDER 5000 EACH
620 SKYLINE DRIVEJACKSONTN383015816712413838429CHARITABLE
VILLAGE CHURCH HISTORICAL
620 SKYLINE DRIVEJACKSONTN3830158167124137586CHARITABLE
VOLUNTEER AUXILLARY
620 SKYLINE DRIVEJACKSONTN38301581671241324190CHARITABLE
WEST TN REHAB CONT EDUCATION
620 SKYLINE DRIVEJACKSONTN38301581671241320774CHARITABLE
WHEELCHAIR BASKETBALL
620 SKYLINE DRIVEJACKSONTN3830158167124139552CHARITABLE
WOODS ARTHUR AND ANDREA
620 SKYLINE DRIVEJACKSONTN38301581671241331000CHARITABLE
WEST TN CENTER FOR CHILD DEVELOPMEN
620 SKYLINE DRIVEJACKSONTN38301581671241318798CHARITABLE
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants65TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATESIdentifier
Return ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2ReturnReference
ExplanationALL GRANT REQUESTS ARE REVIEWED BY THE FINANCIAL ASSISTANT PRIOR TO ISSUING CHECKS TO ENSURE THE USE MATCHED THE MISSION OF THE FUND. ALL GRANT REQUESTS ARE ALSO REVIEWED AND APPROVED BY THE FOUNDATION'S PRESIDENT BEFORE CHECKS ARE ISSUED.Explanation

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions4NumberOfContributions
Noncash Contribs Rptd F990394786NoncashContribsRptdF990
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE EXECUTIVE AND FINANCE COMMITTEE REVIEW THE 990 AND RECOMMEND IT FOR APPROVAL TO THE FULL BOARD OF DIRECTORS.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CTHE CONFLICT OF INTEREST FORMS ARE FORWARDED TO THE COMPLIANCE OFFICER OF THE HOSPITAL AND REVIEWED FOR ANY CONFLICTS, WHICH MUST THEN BE DISCLOSED TO OUR FULL BOARD FOR ACTION.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE FOUNDATION IS AN AFFILIATE OF THE JACKSON MADISON COUNTY GENERAL HOSPITAL; ALL COMPENSATION IS DETERMINED BY THE HOSPITAL.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19NO DOCUMENTS AVAILABLE TO THE PUBLIC
RECONCILIATION OF CHANGES - OTHERFORM 990, PART XI, LINE 9FUNDRAISING EXPENSES REPORTED AS EXPENSE IN FINANCIALS 52,250 FUNDRAISING EXPENSES REPORTED AS EXPENSE IN FINANCIALS -52,250

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